Abstract
Purpose :
The pivotal trials for the ILUVIEN (FAc) implant were the Fluocinolone Acetonide for Diabetic Macular Edema (FAME) trials. However, these trials pre-dated the use of anti-VEGF injections in DMO. Real-world use of ILUVIEN therefore provides data on the response to the FAc implant in patients with chronic DMO who have had a prior insufficient response to anti-VEGFs.
Purpose: To assess anatomical and visual responses to the FAc implant.
Methods :
A retrospective consecutive case series from 10 patients (11 pseudophakic eyes) with chronic DME. 8/11 eyes had previously been treated with anti-VEGF agents (mean 14; range, 0 to 35) and an insufficient response confirmed prior to treating with ILUVIEN. The average follow up period was 15 months (range, 1 to 36 months). Central macula thickness (CMT) and volume (CMV) were monitored along with visual acuity (VA) and intraocular pressure (IOP).
Results :
At the last observation point, mean CMT decreased by 127±147 µm (mean±SD) from a baseline of 386±124 µm. In these eyes, 82% of eyes (n=9/11) CMT was <300 µm. CMV also decreased by 0.85±1.55 mm3 from a baseline of 9.04±1.65 mm3. In 4 patients starting VA was good (>65 letters), the remaining 6 eyes had poor/moderate starting VA which improved in 4/6 cases. Four eyes received IOP-lowering medications after treatment with ILUVIEN, one required selective laser trabeculoplasty.
Conclusions :
In this real world cases series, ILUVIEN following suboptimal responses to repeated anti-VEGF injections, led to consistent drying of the macula and in patients with poor VA it led to improved VA in most cases.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.